Medical Billing in New Hampshire
Soft Home Global provides billing, AR follow-up and denial appeals for New Hampshire practices and billing companies at $1,750 per seat per month. Full time, worked during New Hampshire business hours, inside your own system.
What is specific to New Hampshire
New Hampshire Medicaid delivers most benefits through its Medicaid Care Management programme, so the majority of claims go to contracted managed care plans rather than to state fee-for-service.
New Hampshire’s Medicaid programme is New Hampshire Medicaid. Practices with a meaningful New Hampshire Medicaid mix usually need it worked as its own queue rather than mixed into commercial follow-up, because the submission path, the timely filing window and the appeal route are all different.
What a medical billing seat does in New Hampshire
Aged accounts receivable called until they close, and denials read, appealed and tracked.
In New Hampshire the queue that costs the most is New Hampshire Medicaid, because its filing window and appeal route are not the commercial ones.
- Worklist worked from the difficult end, not the easy end
- Every call logged with the payer reference and the outcome
- Denials categorised so the same reason stops recurring
- Appeals written and submitted, not just re-bills
- Weekly written summary of what moved and what did not
- Worked during New Hampshire business hours, not queued overnight
Most of the New Hampshire work we see comes out of Manchester, Nashua and Concord, though nothing about a seat depends on where your office is — the queue is worked through your system, not from your building.
New Hampshire borders 3 states, and practices near those lines almost always carry at least one out-of-state Medicaid enrollment. That is a separate portal, a separate filing window and a separate appeal route from New Hampshire Medicaid, and it is the queue that most often goes unworked because it belongs to nobody.
What New Hampshire law gives you
15 calendar days for a clean electronic claim; 30 calendar days for a clean non-electronic (paper) claim. If the insurer denies or pends, it has 15 days (electronic) / 30 days (paper) to notify; after receiving requested additional info it must adjudicate within 45 calendar days, and if the notice is not given the claim is deemed clean.
New Hampshire Medicaid, in practice
Statewide mandatory managed care (Medicaid Care Management): "Medicaid Care Management (MCM), or managed care, delivers New Hampshire Medicaid health benefits and additional services through contracts between the Department of Health and Human Services (DHHS) and managed care organizations (MCOs)... In New Hampshire, there are three Medicaid Health Plans to choose from: AmeriHealth Caritas New Hampshire, NH Healthy Families, WellSense Health Plan." Source
Several service lines are carved OUT of the MCOs and must be billed fee-for-service to NH Medicaid/DHHS rather than to the member's health plan: "Some of your services will stay under New Hampshire Medicaid through the DHHS. These include children's dental care, nursing home, and home and community-based care (HCBC) services." A biller who routes a pediatric dental or HCBS claim to AmeriHealth/NH Healthy Families/WellSense will have it rejected. Source
On the commercial side the dominant Blue plan here trades as Anthem Blue Cross and Blue Shield New Hampshire, which matters mainly because its portal and its appeal route are the ones your seat will spend the most time in. Source
We have not been able to source New Hampshire’s own Medicaid filing limit from the regulation itself, so this page does not quote one — the federal floor is twelve months from the date of service and a state may set a shorter window. Ask your New Hampshire Medicaid representative for the figure in writing before you rely on it. The states we could source are listed here.
Working New Hampshire hours
New Hampshire runs on Eastern time, 10 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 7pm to 3am, and 6pm to 2am once the clocks go forward. Pakistan does not observe daylight saving, so the shift moves on this side rather than yours.
That is the part that decides whether follow-up happens at all: a payer’s phone lines are open on New Hampshire hours and nobody else’s.
What it costs in New Hampshire
$1,750
Per seat, per month, in US dollars — $21,000 a year for one full-time person, forty hours a week, on New Hampshire hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in New Hampshire run $1,550 to $2,600; the full list is published.
That is the entire invoice. Run your own figures against a percentage vendor or a hire rather than take ours.
Getting started in New Hampshire
About a week from a signed agreement to a person working your queue, and that week of training on your workflow is not billed on top. The work happens in your own system under a login you issue, so there is nothing to migrate and nothing to install. The week, step by step, and what is signed before anyone has access.
Questions
Do you work with New Hampshire practices?
Yes. New Hampshire accounts are worked during New Hampshire office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about New Hampshire?
New Hampshire Medicaid delivers most benefits through its Medicaid Care Management programme, so the majority of claims go to contracted managed care plans rather than to state fee-for-service.
When does a New Hampshire payer have to pay a clean claim?
15 calendar days for a clean electronic claim; 30 calendar days for a clean non-electronic (paper) claim. If the insurer denies or pends, it has 15 days (electronic) / 30 days (paper) to notify; after receiving requested additional info it must adjudicate within 45 calendar days, and if the notice is not given the claim is deemed clean. A claim sitting past that is not merely late, it is late against a statute, and the follow-up call changes from "when might this be paid" to "this passed your statutory window on a specific date".
How much does medical billing cost in New Hampshire?
$1,750 per seat per month — $21,000 a year for a full-time person, forty hours a week. Every seat price is published at softhomeglobal.com/pricing.
What hours will somebody actually be working our New Hampshire queue?
New Hampshire is on Eastern time, 10 hours behind Rawalpindi. The shift here runs 7pm to 3am so your seat is at a desk for your full working day, shifting to 6pm to 2am while daylight saving is in force — Pakistan does not observe it, so the change happens on our side.
Do you handle New Hampshire Medicaid as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. New Hampshire Medicaid has its own submission path, its own filing window and its own appeal route, and working it in the same worklist as commercial claims is how the deadlines get missed.
Is this a percentage of what you collect?
No — a flat monthly rate per seat, published at softhomeglobal.com/pricing. A percentage bills you most in your best month and points the vendor at the easy accounts.
What is the minimum commitment, and how quickly can somebody start?
One seat for one month, cancellable on thirty days notice, and about a week from a signed agreement to a person working your queue. The week of training is not billed. The steps are at softhomeglobal.com/how-it-works.
Is our patient data safe offshore?
A Business Associate Agreement is signed before anyone has access, and the work happens in your own system under a login you issue, so every action is attributable to a person in your audit trail. The controls are listed at softhomeglobal.com/security.
Next step
One seat on your New Hampshire work
Twenty minutes on a call is enough to tell whether this fits. If it does not, I will say so.
Or write to ops@softhomeglobal.com